Central Venous Catheter (CVC) Demonstration |
For the complete video with all my tips, check out the complete video in the Foundations course
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In this video I go through an incredible amount of detail about CVC insertion.
The Aims and Indications
Anatomy and under the skin view
Setup and Preparation
The CVC Kit and extra necessary items
US guided CVC insertion demonstration
the full video also has steps to identify and prevent serious complications
and how to troubleshoot a difficult CVC insertion
available here!
anaesthesia.thinkific.com/cou...
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Пікірлер: 12
As for fixation of the catheter (16:34): the small pad/clip thing is to be sutured right next to the puncture site, preventing the migration of the central line (inwards, but especially outwards) by patient movement or dressing changes; this is also a safety feature allowing the central line to be retracted (if you didn´t do an atrial ECG during placement to confirm location in front of atrium, but instead opted for doing an X-ray, and noticed it was inserted a bit too deep) or in mobile patients to safely pull out the whole central line (without ripping off one of the legs, which could lead to an air embolism due to the now open lumen) if it accidentally snagged on something... As for suture kit: you don´t need scissors and pincers - just a needle driver, as you already got a scalpel included in the kit to cut the suture.
@tammybambini1096
5 ай бұрын
and this clip is 2cm wide - so you can always confirm your CVC insertion depth using the markings on the catheter and compare it to the documentation done after CVC placement ;)
Nice, thank you! At 14:05 I´d recommend to not just "dab" any blood, but put a gauze pad there and keep it all the time with a bit of finger pressure, removing it only during the insertion of the dilatator and reapplying it as soon as this has passed the skin, and then remove it just before the central line goes into the skin - that way you´ll never flood the area with blood (especially important if you insert a dialysis catheter as the lumen there is way larger) and prevent any air embolisms coming from the puncture location.
I´d recommend to do a step-down- or slide-down technique when advancing the CVC needle through the tissue, always visualizing the needle tip; also confirm the location of the Seldinger wire (13:27) in two planes (short and long axis) just to be safe it´s in the correct place.
@ABCsofAnaesthesia
5 ай бұрын
Great tips tammy!
Excellent video as always Lahiru, greetings from Chile.
@ABCsofAnaesthesia
5 ай бұрын
Thank you very much!
Thanks😊
@ABCsofAnaesthesia
5 ай бұрын
Welcome 😊
How do you approximate insertion length in obese patients? Is there a way to objectively measure e.g cxr beforehand or do you just go by estimation?
@ABCsofAnaesthesia
5 ай бұрын
I usually go by estimation. But roughly measure distance from needle insertion point to sternal angle. Also being slightly to far in is better than not enough, you can pull back a cvc and keep it sterile but wouldnt recommend advancing a cvc not far enough (the visible non sterile part now enters the patient)
@Firestorm189
5 ай бұрын
@@ABCsofAnaesthesia Thanks, appreciate the videos.